Preventive Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Microbiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
PLoS One. 2021 Aug 11;16(8):e0255994. doi: 10.1371/journal.pone.0255994. eCollection 2021.
The association between Coronavirus Disease 2019 (COVID-19) and abortion has been debated since the beginning of the COVID-19 pandemic. We aimed to conduct this systematic review to understand better the potential effects of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) on fetal loss in infected mothers presented with abortion following this infection.
We included articles published in PubMed/Medline, Web of Science, clinicaltrials.gov, and Embase databases in 2019 and 2020 through a comprehensive search via appropriate keywords, including COVID-19 and abortion synonyms. All studies with the abortion data in COVID-19 confirmed pregnant females were collected.
Out of 208 potentially relevant articles, 11 articles were eligible to include in the systematic review. The included reports were published because of the following reasons: (1) First-trimester miscarriage; (2) Late miscarriage; (3) complication of COVID-19 infection in pregnancy; (4) COVID-19 disease in artificial pregnancy. First-trimester abortion was found in 5 studies, and second-trimester abortion in 7 studies. Two patients acquired infection during the hospital stay while they were referred for abortion. Reports related to abortion in pregnant females with COVID-19 show that most miscarriages due to COVID-19 in the first trimester were due to placental insufficiency.
There is an increased risk of abortion in mothers with a positive test result of SARS-CoV-2, which several case reports and case series have identified during the pandemic. Placental inflammation during the viral infection may result in fetal growth retardation and induce abortion. There has not been any consistent evidence of vertical transmission of the virus from mother to fetus, which requires further investigation.
自 2019 年冠状病毒病（COVID-19）大流行开始以来，COVID-19 与堕胎之间的关联一直存在争议。我们旨在进行这项系统评价，以更好地了解严重急性呼吸系统综合征冠状病毒 2（SARS-CoV-2）在感染母亲感染 COVID-19 后出现流产时对胎儿丢失的潜在影响。
我们通过使用适当的关键字（包括 COVID-19 和堕胎的同义词）在 2019 年和 2020 年在 PubMed/Medline、Web of Science、clinicaltrials.gov 和 Embase 数据库中进行了全面搜索，纳入了已发表的文章。所有包含 COVID-19 确诊孕妇流产数据的研究均被纳入系统评价。
在 208 篇可能相关的文章中，有 11 篇文章符合纳入系统评价的标准。纳入的报告是因为以下原因而发表的：（1）早期流产；（2）晚期流产；（3）妊娠期间 COVID-19 感染并发症；（4）人工妊娠 COVID-19 疾病。5 项研究中发现了早期流产，7 项研究中发现了中期流产。2 例患者在住院期间因流产而感染。与 COVID-19 孕妇流产相关的报告表明，由于 COVID-19 导致的大多数早期流产是由于胎盘功能不全引起的。
在 SARS-CoV-2 检测结果为阳性的母亲中，流产的风险增加，这在大流行期间已经有一些病例报告和病例系列研究确定。病毒感染期间的胎盘炎症可能导致胎儿生长迟缓并引起流产。目前尚无病毒从母亲垂直传播给胎儿的一致证据，这需要进一步研究。
